Oral contraceptives increase insulin resistance in adolescent PCOS

NEW YORK (Reuters Health) – Oral contraceptives improved features of
polycystic ovary syndrome (PCOS) in adolescent girls but have an
unfavorable impact on insulin resistance, according to a report in the
February issue of Fertility and Sterility.

Dr. George Mastorakos and colleagues from Athens University School of
Medicine, investigated the effect on carbohydrate metabolism of two
combined oral contraceptives containing cyproterone or desogestrel as
progestogenic compounds in 36 adolescent girls with PCOS.

Although body mass index and waist-to-hip ratio remained unchanged
during treatment, three patients developed impaired fasting glucose and
another three patients developed impaired glucose tolerance after 12 months of treatment, the authors report.

The fasting glucose-to-insulin ratio declined after 12 months of
treatment in both groups, the results indicate, although the decline was
statistically significant only in the cyproterone group. Similarly, the
insulin sensitivity index decreased significantly and insulin secretion
increased significantly only in the cyproterone-treated group.

“Both combined oral contraceptive formulations are effective in
ensuring normal menstrual cyclicity and in reducing hirsutism in adolescent
patients with PCOS,” the authors note. “Both treatments have an unfavorable
impact on insulin resistance. However, as has been suggested in the past, this effect is not translated into a clinically relevant major impact.”
“The positive correlation between insulin values and body mass index in
women with PCOS suggests that obese teenage patients, along with
psychological support, should also be encouraged to lose weight and
exercise in an effort to improve the clinical and metabolic features of
the syndrome,” the researchers conclude.